Melissa Jacob

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

070022999 Issued in IL

Legal business name

MELISSA JACOB

Practice address

420 N Wolf Rd
Northlake, IL 60164-1670

Phone

(708) 562-4300

NPI assigned

Mar 20, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kent G Lattanzi

Title

Human Resource Assistant

Phone

(410) 667-7200

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Jacob

  • Physical Therapist
  • Northlake, IL
  • NPI 1891255659
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1205330628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3N464 PATRICIA LN",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261210",
            "telephone_number": "630-850-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N WOLF RD",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601641670",
            "telephone_number": "708-562-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA JACOB",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "LATTANZI",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "HUMAN RESOURCE ASSISTANT",
        "authorized_official_telephone_number": "410-667-7200"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070022999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luna Optics LLC
• Daniel Michael Lynch I, PHARMD
• Marathon Health, LLC (Live Well Health Center (UWC-Northlake))
• Mary Alice McNeice, MS-CCC-SLP/L
• McParland Chiropractic, P.C.
• Meridian Homecare, Inc.
• M Maher Najjar, M.D
• Michelle Nguyen
• Northlake Chiropractic Inc.
• Northlake Dental Clinic PC

• Physical Therapy Clinic/Center in Northlake, IL
• Providers in Northlake, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.